Restraint debate reignited over hospital mental health case

ELEANOR HALL: Now to the allegations in South Australia that mental health patients are being restrained in overcrowded hospitals, despite national calls for the practice to be ended.

Health officials say they did shackle an allegedly violent patient to an emergency department bed but that they did so because there was no room in the high security ward.

In Adelaide, Rebecca Brice reports.

REBECCA BRICE: It happened four years ago, but Jeanette Walsh says she vividly remembers the day she walked into an Adelaide hospital emergency department to find her schizophrenic daughter in shackles.

JEANETTE WALSH: I was so upset and when I, I cried all the way back to the car through the streets of Woodville and a few people said, you know, what’s wrong? I just said it's just what they've done to my daughter.

REBECCA BRICE: She was told her daughter had assaulted a security guard.

JEANETTE WALSH: She said she pushed him because she wanted to go out for a cigarette. That upset me too. At the time I was there she wanted to go to the toilet and I said well I'll take her to the toilet and they said oh no and they shoved a bed pan under her still shackled.

REBECCA BRICE: Jeanette Walsh wanted to tell her story after another case emerged of a violent patient shackled in the Flinders Medical Centre.

The health department admits the man was restrained over a four day period because there were no high security beds available.

Jack Snelling is the Health Minister.

JACK SNELLING: It will always be the case, not only in mental health, but right across our health system that there'll be periods of very, very high demand where we're not able to accommodate people in the beds that they require as quickly as we would like to. That will always be the case and unfortunately sometimes it requires, particularly for the protection of themselves, for staff and other people around them, that those sort of measures has to be taken.

REBECCA BRICE: But the state's chief psychiatrist, Dr Peter Tyliss is playing down resourcing issues.

PETER TYLISS: I think that's an inaccurate reflection of the use of restraint. The month of February, March in Adelaide, we may have increased numbers of presentations to hospital departments, emergency departments with alcohol or amphetamine intoxication and these people might not be in a state where they can actually control their behaviour and that sometimes leads, you know, after all efforts have been exhausted to manage that, to the use of restraint.

REBECCA BRICE: But you just said sometimes there are increased cases of it coming in in February and March, isn't that saying that it is linked to demand?

PETER TYLISS: Well, as I said, it is regarding the specific presentation.

REBECCA BRICE: In its first report card in November, the National Mental Health Commission recommended phasing out the use of restraints, as well as seclusion methods.

The peak sector body, the Mental Health Council of Australia, agrees. Frank Quinlan is the CEO.

FRANK QUINLAN: The question here is whether it's appropriate for us to say to people who are experiencing high levels of distress that our system is busy doing other things and therefore we're going to lock you up for a little while because there are high demands on rest of our system.

REBECCA BRICE: Last year 116 people were restrained in South Australia, up from 87 the year before. But Dr Tyliss says that's because the state is only now starting to collect data.

PETER TYLISS: There is an upward trend but I'd hasten to add that that's most likely due to the reporting efforts that we've made.

REBECCA BRICE: According to the national commission, Victoria and Western Australia are the only other states to keep such data.

Frank Quinlan from the Mental Health Council says that's not good enough.

FRANK QUINLAN: Clearly we need to know how often we're using seclusion and restraint if we're going to better understand it, but it's also the evidence as to effects of seclusion and restraint because in many, many circumstances, the use of seclusion and restraint can actually exacerbate people's conditions.